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Monterey Institute of Psychotherapy

Recovery Intensive Outpatient Therapy from Out of Town

Eating disorder programs are generally focused on helping a client gain control of behaviors such as self-starvation, food restricting, bingeing, purging and obsessions about food, weight and appearance. Residential treatment often is successful in helping clients accomplishing their goals, but – for reasons that remain complex -- the majority of clients relapse. Sometimes the transition back to the home environment and accompanying triggers is too great. Sometimes there isn’t sufficient step-down time to allow unmasking of the fears that were once dealt with by the eating symptoms, so the client feels overwhelmed and terrified. Often the eating disorder served many functions, and residential therapy is unable to develop healthy replacements for these functions. Table 1 lists some of the functions eating disorder symptoms can enable. Without the eating disorder, the client feels unable to cope.

Our program helps the client master these issues in individual psychotherapy and then in the real world. We use “coaching” to help the client recognize what they fear, to “show-up” for life’s obligations, and to slowly confront their fears through exposure therapy until they are mastered. We learn, practice and rehearse new patterns of thinking, feeling and behaving on a daily basis. Clients often come to the clinic for three hours of therapy each day, augmented by peer or life coach counseling outside the office to practice the behaviors they fear.

The result of our Intensive Outpatient Therapy is the client’s reduction and then elimination of the need to revert to the eating disorder when feeling overwhelmed. Clients learn new tools and gain feelings of competency, effectiveness and pride as they deal productively with previously overwhelming emotions.

Recovery Program, Outpatient Therapy and Intensive

· Sex is out of control and the person is acting outside their value system

· Sex is interfering with establishing a healthy intimate relationship or marriage

· Sex has resulted in difficulty with work such as browsing internet pornography or inability to concentrate

· Sex is obsessive or compulsive

In our decades of experience, we have found that any type of addictive behavior is an indication that one’s life is out of balance. There are multiple reasons:

· Anger or rage related to powerlessness experienced in childhood

· Depression or anxiety that gets effectively relieved by distracting oneself with sex

· Fears related to relationships and intimacy

· Attachment issues where an individual finds that they can neither stay in nor leave a relationship

· A person lacks skills to effectively navigate their world because of social anxiety, obsessive compulsive perfectionism, bipolar-like mood changes, and so on

· Unfinished, unresolved issues from childhood, often revolving around trauma in the family of origin

The TreatmentTreatment begins with a thorough assessment. Individuals can be widely divergent in their addictive behaviors, so interventions are based on a complete delineation of the contributing factors.

We will work with the individual or couple as available and appropriate. For out-of-town clients, we offer an Intensive Outpatient Program (IOP) consisting of 3 hours of daily treatment that includes individual or couples therapy plus group therapy. Participation in a 12-step program is also encouraged between sessions. If co-dependency is an issue, special treatment for the identified client or partner is available.

Paraphilia/Gender ConfusionIndividuals sometimes develop atypical sexual arousal patterns (paraphilias) that interfere with intimacy as a couple. Examples include: fetishes, transvestism, preferences for violence, and so on. In our experience, these paraphilias are often tied to childhood trauma caused by neglect. We also work with issues related to gender confusion and dissatisfaction with one’s sense of self and identity.

We can conductan initial assessment by phone to provide more specific guidance prior totherapy.

CostsIntensive Outpatient Therapy is covered by most insurance plans. Call us with your insurance information, and we can help you confirm coverage, including your out-of-pocket costs based on the number of treatment hours each day.

AssessmentsIndividuals are invited to visit Monterey over a four-day weekend, or for a full week (hourly rates apply), for an assessment prior to committing to a complete therapeutic plan.

Intensive Outpatient Programs

Most individuals marry for good reasons -- and for bad reasons! The good reasons include finally finding that one extraordinary person who you weren't even sure existed. Life feels magical: colors are brighter, song lyrics have more meaning, and the sex is passionate. You feel good when you are with this person, and think of them constantly when you are not. You are no longer alone; you have a partner with whom you can explore the universe, create, learn, laugh, play.

And the bad reasons? We often choose partners who uniquely re-create what therapists call "past unfinished business." And so begins the disenchantment, the frustration, hurt, disappointment, the distance, the power struggles.

It starts small. They leave the cap off the toothpaste; they load the dishwasher all wrong, if they load it at all. They don't talk or they always want to talk. They want sex all the time or, when they don't, are they no longer attracted?

You can't believe the person you thought was so amazing is now so inconsiderate! Were you wrong then or are you wrong now about them? Or is it you? Marital therapists during the last few decades were, in general, remarkably ineffective in helping couples create sustainable and adequate relational improvement, but much has changed in the last few years. The field of marital therapy has evolved and the current approaches work much better. Often much can be done to improve a failing relationship, to reestablish the "good" and resolve the "bad.”

The complex challenge is that for partners to make changes, they need a climate of teamwork, respect and positive regard for each other. But the relationship is already in danger or they wouldn’t be in marital therapy. How to achieve the initial relational shifts necessary for changes to follow? We have achieved great success with a three-part process. First is a cessation of the current hostilities, help with damage control and re-creation of the conditions necessary for a caring, working alliance between the partners. The second phase involves the teaching and practice of skills to help the couple maintain relational health and prevent problems from re-accumulating. These include: ·

skills for nourishing the relationship·

establishment of rituals of intimacy·

time management·

balanced lifestyle·

problem-solving skills·

identifying and expressing feelings and desires·

dealing with unsolvable problems,

and· expressing anger constructively as a platform for developing even greater intimacy.

Finally, to allow these changes to truly take root requires the third phase: examining how each partner's unfinished business previously vined its way into the relationship. Using the strengthened relationship as a vehicle, we revisit and resolve the previously unfinished issues in each person's life. This process has the potential for deepening intimacy, but it is also difficult to achieve the movement and momentum required in once-a-week outpatient therapy. Coordinating schedules, work demands, childcare, finding time to practice the new skills adequately before the next session, travel, arguments that fester for a week, all conspire in a one step forward and two steps back outcome that slows change and can increase a sense of hopelessness. The answer . . . ?

Consider taking a vacation cure. Re-create an atmosphere of fun and play and breathe new life into the relationship. Walk along the beach while enjoying the sunset; have dinner at any one of many fine restaurants, then focus on the nightly relationship-enhancing homework. Spend 7 to 10 days in a resort-like setting, away from daily pressures, work and the children.

This is a Marriage Retreat and it is quite an effective way to resurrect a relationship. One 90- minute session in the morning focuses on couple's issues, and one late in the afternoon works on the past baggage that has been blocking intimacy with your partner. This past baggage can be issues that emerged in infancy and early childhood. More and more research is showing that our early interactions with caretakers affect our ability to form healthy bonds and can write the blueprint for later relationships. Early developmental traumas can drive the individual to reenact destructive or confusing early experiences. Revisiting these earlier traumas while the partner is in the room often brings clarity to the origin of many current day arguments .Often these arguments are flashbacks, of a sort, triggered more by the past than the present. This realization alone, can create understanding and compassion where conflict and confusion reigned. Additionally, learning how to be more considerate, passionate, mindful and loving on a day-to-day basis encourages the partner to reciprocate. Couples who couldn’t stand one another eventually rediscover the affection that was the glue of their relationship.

These are the other key features of successful retreats. Working with a male/female co-therapy team is incredibly useful, so one doesn't feel ganged-up on by the opposite sex. The male therapist works with one partner; the female with the other, all in the same room. A second feature is weekly follow-up coaching via Skype after the couple returns home to maintain the changes and incorporate them into busy stressful lifestyles. Finally some work on sexual enhancement is useful since some tricks don't make it into grocery checkout magazines. One of the best marital retreats available is in gorgeous Monterey, California, with nationally known therapists Dr. Mark Schwartz and Lori Galperin, MSW, once part of the Masters & Johnson Institute team.

Working with Mark and Lori in Monterey, CA

With more than 25 years' experience helping hundreds of couples, their retreat interweaves the magic of whale watching, hiking through Big Sur or golfing at Pebble Beach with therapeutic insight, wisdom, behavioral therapy and deeper interventions to restore and enrich the relationship.

If your marriage seems to have dissolved from “good” to “bad,” don’t give up. Take a marriage holiday to Monterey and rediscover the partner you fell in love with.